Welcome to the A-Line Staffing Solutions Covid-19 Symptom Screening Questionnaire Have you had any signs or symptoms of a fever in the past 24 hours such as chills, sweats, felt "feverish" or had a temperature that is elevated for you/100.4F or greater?* Yes No Do you have any of the following symptoms?*• Cough • Shortness of breath or difficulty breathing • Fatigue • Muscle or body aches • Headache • New loss of taste or smell • Sore throat • Congestion or runny nose • Nausea or vomiting • Diarrhea Yes No Have you traveled internationally or outside of state in the last 14 days? Or, have you had any close contact in the last 14 days with someone with a diagnosis of COVID-19?* Yes No Have you had contact with someone who has been exposed to covid?* Yes No Please enter your name below:* First Last PhoneThis field is for validation purposes and should be left unchanged. Δ
